Spaceflight Associated Neuro-Ocular Syndrome
- 1st Edition - July 16, 2022
- Imprint: Academic Press
- Editors: Andrew G. Lee, Joshua Ong
- Language: English
- Paperback ISBN:9 7 8 - 0 - 3 2 3 - 9 1 5 2 4 - 3
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 9 1 5 2 5 - 0
Prolonged microgravity exposure during long-duration spaceflight (LDSF) produces unusual physiologic and pathologic neuro-ophthalmic findings in astronauts. These… Read more
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Request a sales quoteProlonged microgravity exposure during long-duration spaceflight (LDSF) produces unusual physiologic and pathologic neuro-ophthalmic findings in astronauts. These microgravity-associated findings collectively define the Spaceflight Associated Neuro-ocular Syndrome (SANS). In this book, the editors compare and contrast prior published work on SANS by the National Aeronautics and Space Administration’s (NASA) Space Medicine Operations Division with retrospective and prospective studies from other research groups. The book describes the possible mechanisms and potential etiologies for SANS, and provides an update and review on the clinical manifestations of SANS including: unilateral and bilateral optic disc edema, globe flattening, choroidal and retinal folds, hyperopic refractive error shifts, and focal areas of ischemic retina (i.e., cotton wool spots). The ocular imaging findings (e.g., retinal nerve fiber layer, optic disc, and choroidal changes on optical coherence tomography) of SANS is also described, including the intraorbital and intracranial findings on orbital ultrasound and magnetic resonance imaging. The knowledge gaps for in-flight and terrestrial human research including potential countermeasures for future stud is also explored, including reports on the in-flight and terrestrial human and animal research being investigated by NASA and its partners to study SANS both prospectively and longitudinally and in preparation for future long duration manned missions to space including the moon, the asteroid belt, or Mars. We think this is a unique topic and hope that NASA and its research partners continue to study SANS in preparation for future longer duration manned space missions.
- Written in an easy-to-read manner, the book adopts a translational approach and explores the science and the clinical manifestations of Space flight associated neuro-ocular syndrome. It is also multi-disciplinary and suitable for both clinicians and researchers in ophthalmology, neurology, and aerospace medicine interested in SANS
- SANS is a unique space flight disorder that has no terrestrial equivalent. The book involves contributions from international experts across multiple disciplines to tackle the problem of SANS
- Summarizes and reviews the current findings of SANS, including possible mechanisms and potential etiologies, clinical manifestations, current reports on the in-flight and terrestrial human and animal research, and ocular imaging findings
Researchers in neurology, ophthalmology, neurologists, ophthalmologists, neuroradiologists, researchers in aerospace medicine. Researchers in various disciplines
- Cover image
- Title page
- Table of Contents
- Copyright
- Contributors
- About the editors
- Foreword
- Preface
- Acknowledgments
- Chapter 1. An introduction to space medicine and the physiological effects of spaceflight on the human body
- Introduction
- Health hazards during spaceflight
- Radiation
- Bone loss and nephrolithiasis
- Skeletal muscle atrophy
- Isolation and behavioral health
- Vision changes and Spaceflight Associated Neuro-Ocular Syndrome (SANS)
- Chapter 2. Neuro-ocular findings and mechanisms in Spaceflight Associated Neuro-Ocular Syndrome
- Optic disc edema
- Globe flattening and hyperopic shift during and after long-duration spaceflight
- Choroidal expansion and folding during spaceflight
- Chapter 3. Optical coherence tomography and Spaceflight Associated Neuro-Ocular Syndrome
- Optical coherence tomography
- Ocular changes in Spaceflight Associated Neuro-Ocular Syndrome
- Optical coherence tomography and disc edema
- Bruch's membrane opening deflection
- The choroid in Spaceflight Associated Neuro-Ocular Syndrome
- Conclusion
- Chapter 4. Clinical neuroimaging of Spaceflight Associated Neuro-Ocular Syndrome
- Overview
- Orbital findings
- Pituitary findings
- Cerebral findings
- Terrestrial analogs to microgravity
- Chapter 5. Genetics, vitamins, and Spaceflight Associated Neuro-Ocular Syndrome
- Introduction
- One-carbon biochemistry and genetics—a primer
- One-carbon biochemistry, genetics, and Spaceflight Associated Neuro-Ocular Syndrome
- Ground analogs
- Potential Mechanism(s) of Spaceflight Associated Neuro-Ocular Syndrome
- Potential countermeasure for Spaceflight Associated Neuro-Ocular Syndrome
- Summary
- Chapter 6. Glymphatic system and Spaceflight Associated Neuro-Ocular Syndrome
- Introduction
- Discussion
- Conclusion
- Chapter 7. Mechanical alterations of the brain and optic chiasm in Spaceflight Associated Neuro-Ocular Syndrome
- Preface
- The brain and optic chiasm during low earth orbit and head-down tilt bed rest
- Proposed mechanism of optic nerve elongation
- Potential treatment for Spaceflight Associated Neuro-Ocular Syndrome
- Chapter 8. Intraocular pressure and Spaceflight Associated Neuro-Ocular Syndrome
- Intraocular pressure changes in microgravity
- Mechanisms of intraocular pressure elevation
- Consequences of intraocular pressure elevation
- Relationship between intraocular pressure, cerebrospinal fluid pressure, and retinal vasculature
- Potential therapies
- Chapter 9. Intraocular and intracranial pressure relationships for Spaceflight Associated Neuro-Ocular Syndrome countermeasures
- Introduction
- Intraocular pressure and intracranial pressure changes during spaceflight
- IOP–ICP relationships at the optic nerve head in health and disease
- SANS countermeasures—experimental and theoretical approaches
- Reduction of intracranial pressure
- Elevation of intraocular pressure
- Limitations of potential Spaceflight Associated Neuro-Ocular Syndrome countermeasures
- Conclusion
- Chapter 10. Pathophysiology of cerebral edema and its connection to Spaceflight Associated Neuro-Ocular Syndrome
- Introduction
- Blood–brain barrier and normal neuronal function
- Possible mechanisms of cerebral edema
- Possible relationship of cerebral edema to Spaceflight Associated Neuro-Ocular Syndrome
- Relevant anatomy of optic disc and optic nerve
- Conclusion
- Chapter 11. Cerebral hemodynamic changes and invasive/noninvasive monitoring for Spaceflight Associated Neuro-Ocular Syndrome
- Introduction
- Review of cerebrovascular physiology
- Brain monitoring for spaceflight
- Brain physiological changes in spaceflight
- Conclusions and future directions
- Chapter 12. Terrestrial analogs for Spaceflight Associated Neuro-Ocular Syndrome
- Introduction
- Parabolic flight
- Dry immersion
- Head-down tilt bed rest
- Ethical considerations
- Chapter 13. Potential countermeasures for Spaceflight Associated Neuro-Ocular Syndrome
- Introduction
- Spaceflight Associated Neuro-Ocular Syndrome hypotheses and countermeasures
- Conclusions and future challenges
- Chapter 14. Spaceflight Associated Neuro-Ocular Syndrome in astronauts—the ICP hypothesis
- Introduction
- Elevated intracranial pressure
- Dysregulation of intracranial pressure and intraocular pressure
- Air composition in the International Space Station and during long-duration spaceflight
- Exposure to radiation
- Metabolic and genetic predisposition to Spaceflight Associated Neuro-Ocular Syndrome
- Modeling Spaceflight Associated Neuro-Ocular Syndrome in a 1G environment
- Idiopathic intracranial hypertension
- Future directions
- Direct continuous intracranial pressure measurement
- Future treatment modalities
- Chapter 15. Multimodal assessment of visual function and ocular structure for monitoring Spaceflight Associated Neuro-Ocular Syndrome
- Introduction
- Traditional visual function assessment
- Visual acuity
- Contrast sensitivity
- Chromatic sensitivity
- Visual field assessment
- Visual distortion assessment
- Comprehensive assessment using virtual reality
- Limitations of virtual reality–based diagnostics
- Index
- Edition: 1
- Published: July 16, 2022
- Imprint: Academic Press
- No. of pages: 240
- Language: English
- Paperback ISBN: 9780323915243
- eBook ISBN: 9780323915250
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Andrew G. Lee
Dr. Lee began his academic career in 1994 as an Instructor in the Department of Ophthalmology, Neurology, and Neurosurgery at Baylor College of Medicine, becoming an Associate Professor in 1998. In 2000, he joined the University of Iowa as an Associate Professor and later became a full Professor. He serves on the editorial boards of 12 journals, including the American Journal of Ophthalmology, and is the Editor in Chief of the Journal of Academic Ophthalmology. A recipient of multiple awards from the American Academy of Ophthalmology, Dr. Lee has a strong interest in resident training and has published extensively on teaching methods in ophthalmology residency programs. In 2009, he joined Houston Methodist Hospital and Research Institute, where he currently serves as Chair of the Blanton Eye Institute and is a Professor at Weill Cornell Medical College.
Affiliations and expertise
Chair of the Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA; Professor of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medical College, New York, NY, USAJO
Joshua Ong
Joshua Ong, MD is a resident physician with a passion for protecting astronaut health. He has conducted research on several space medicine research projects, including a project that launched into space. He has presented at the National Aeronautics and Space Administration (NASA) Human Research Program Investigators' Workshop and strives to continue his lifelong journey in ophthalmology and space medicine.
Affiliations and expertise
School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USARead Spaceflight Associated Neuro-Ocular Syndrome on ScienceDirect